Indocyanine Green (IC Green)

Updated
May 9, 2015
Author: from emails

IndoCyanine
GREEN
Video-angiography in Cerebrovascular Surgery

December 2010
IC Green (Indocyanine Green ) video-angiography is a new technique of
blood-flow measurement that is being used in neurosurgery. The dye is
administered intravenously and used in combination with a special microscope
to obtain high-resolution, high-contrast video images during
micro-neurovascular surgery.
Used in the OR at MMC by neurosurgery

* The OR will order on a patient specific basis. To view order form for
printing click here.
* Send one vial and one amp of diluent to the OR as requested. It is stored in
the Carousel. Each box contains 6 vials of IC green and 6 amps of diluent.

-Only the aqueous solvent provided
should be used for reconstitution. It is specially prepared sterile water
for injection. There have been reports of incompatibility with some
commercially available sterile water for injection products.

-The vial of IC Green should be
reconstituted with the entire contents of the supplied diluent.
Solution must be used within 6 hrs of reconstitution.

Department of Anesthesiology, College of Medicine,
University of Florida, Gainesville 32610-0254.

The effects of fluorescein, methylene blue, and
indocyanine green on hemodynamic variables and on pulse oximetry and co-oximetry
measurements of arterial hemoglobin oxygen saturation (SaO2) and oxyhemoglobin
percentage (% HbO2) were evaluated in 16 anesthetized dogs in vitro by co-oximetry
(% HbO2) and in vivo by pulse oximetry (SaO2). The light absorbance (optical
density) in plasma (range 500 to 800 nm) was measured by a spectrophotometer.
Fluorescein did not affect oximetry measurements, plasma light absorbance in the
range measured, or hemodynamic variables. Methylene blue caused dose-dependent
decreases in measurements made with both forms of oximetry for up to 30
minutes, the decrease being greater and longer lasting with pulse oximetry (P
less than 0.05).

Hemodynamic measurements in 5 dogs showed that methylene
blue (1 to 5 mg/kg) increased arterial pressure transiently, after which
cardiac output, stroke index, and left ventricular stroke work index decreased
and left ventricular end-diastolic pressure and systemic and pulmonary
vascular resistances increased (P less than 0.05 with 5 mg/kg). Methemoglobin
concentration measured by co-oximetry increased significantly (to 19.9 +/-
1.4%, P less than 0.05) 1 minute after 5 mg/kg of methylene blue was injected.
Methylene blue had a dose- and time-dependent effect on plasma light
absorbance, and this effect peaked in the 660- to 670-nm range. The data do
not distinguish the relative contributions of physiology (hemodynamic change), chemistry (methemoglobin
production), and physics (optical properties) to the decrease in pulse
oximetry and co-oximetry measurements that follows injection of methylene
blue. Indocyanine green affected neither hemodynamic variables nor co-oximetry
readings but decreased pulse oximetry readings for up to 10 minutes dose
dependently.